Wnuk Anita Małgorzata
Department of Infectious Diseases, Pomeranian University of Medicine, Szczecin, Poland.
Med Sci Monit. 2003 May;9(5):CR197-200.
The aim of this study was to determine the epidemiology of occupational exposure to HIV infection in health care workers (HCWs).
MATERIAL/METHODS: A survey from 4 hospitals between February 1995 and May 2001 identified 28 HCWs who had been exposed to HIV. The type of exposure to HIV, the circumstances of the incident, the safety precautions applied, and epidemiological information were evaluated in each case. A blood specimen for HIV serological testing was collected at the baseline visit and at 6 weeks, 3 months, 6 months and 12 months follow-up.
The study population consisted of 24 women and 4 men, mean age 34.7 +/- 5.8, including 15 nurses, 9 physicians, 2 nursing assistants, 1 morgue worker, and 1 medical student. These workers had been exposed to blood and infectious body fluid from patients who had AIDS (17 exposures), were HIV-antibody positive and symptomatic (3 exposures), or were HIV-antibody positive and asymptomatic (8 exposures). The exposure types included percutaneous injury (22) and blood or infectious body fluid contact with mucous membranes (2) or intact skin (4). Post-exposure chemoprophylaxis was used by 18 HCWs, 12 of whom reported side effects. None of the HCWs was HIV-seropositive in follow-up after occupational exposure.
Nurses are most at risk for occupational exposure to HIV infection. Post-exposure chemoprophylaxis is effective. Routine post-exposure management is also a good instrument to detect serological markers of HBV and HCV infection among HCWs and patients.
本研究旨在确定医护人员职业暴露于艾滋病毒感染的流行病学情况。
材料/方法:对1995年2月至2001年5月期间4家医院进行的一项调查,确定了28名曾暴露于艾滋病毒的医护人员。对每例病例评估艾滋病毒暴露类型、事件发生情况、采取的安全预防措施以及流行病学信息。在基线访视时以及随访的6周、3个月、6个月和12个月时采集用于艾滋病毒血清学检测的血液标本。
研究人群包括24名女性和4名男性,平均年龄34.7±5.8岁,其中包括15名护士、9名医生、2名护理助理、1名停尸房工作人员和1名医学生。这些工作人员接触了患有艾滋病患者的血液和传染性体液(17次暴露)、艾滋病毒抗体阳性且有症状者(3次暴露)或艾滋病毒抗体阳性且无症状者(8次暴露)。暴露类型包括经皮损伤(22次)以及血液或传染性体液与黏膜(2次)或完整皮肤(4次)接触。18名医护人员使用了暴露后化学预防,其中12人报告有副作用。职业暴露后随访中,没有医护人员艾滋病毒血清学呈阳性。
护士职业暴露于艾滋病毒感染的风险最高。暴露后化学预防是有效的。常规的暴露后管理也是检测医护人员和患者中乙肝和丙肝感染血清学标志物的良好手段。